白内障摘除蓝光滤过型人工晶状体植入术后的临床观察

Clinical observation of blue-light filtering intraocular lens implantation after phacoemulsification

目的比较研究白内障超声乳化植入蓝光滤过型人工晶状体和普通一片式人工晶状体的临床效果。方法选取行自内障超声乳化摘除联合人工晶状体植入患者60例，60只眼，术后裸眼视力大于等于0．8。根据植入人工晶状体的类型不同，分为试验组和对照组，试验组植入YA-60BB人工晶状体组，30只眼；对照组植入AR40e人工晶状体组，30只眼。术后一个月检查患者的对比敏感度、畏光蓝视和色觉等主观视觉症状。结果（1）YA-60BB人工晶状体组对比敏感度和AR40e人工晶状体组相比，术后一个月昼眩光状态1．5cpd空间频率下，和夜眩光状态1．5、3cpd空间频率下，两组对比敏感度相比差异有统计学意义（P〈0．05），蓝光滤过组明显高于非蓝光滤过组。其余状态下，两组相比差异无统计学意义（P〉0．05）。（2）术后一个月两组间畏光症状相比，差异无统计学意义（P〉0．05）。两种晶体间色觉相比也无明显差异。蓝视症状相比，两组间差异有统计学意义（P〈0．05），蓝光滤过组的术后蓝视症状明显少于非蓝光滤过组。结论植入YA-60BB人工晶状体可提高眩光状态下低空间频率下的对比敏感度，也可以减轻患者术后的蓝视症状，而对色觉无负面的影响。

Objective To evaluate the clinical effect of the phacoemulsification operation combined with blue-light filtering YA-60BB intraoeular lens implantation or Sensar AR40e implantation in the elders. Methods Sixty eyes were undergone phacoemulsification with IOL implantation. Uncorrected post-operative visual acuity was equal to or greater than 0.8. Based on the different type oflOL they were divided into 2 groups. Thirty eyes were implanted with blue-light filtering YA-60BB IOL while other 30 cases were implanted with Sensar AR40e IOL. The post-operative visual symptoms of the contrast sensitivity,photophobia,blue opsia and color perception were observed 1 month after operation. Results The contrast sensitivity of the patients with the blue-light filtering IOL was superior to that with the conventional IOL under the condition of glare and 1.5c/d, 3c/d space frequency. There were no significant differences in photophobia and color perception performance between two groups 1 month after operation. While the blue-light filtering IOL can significantly relieve the post-operative blue opsia symptom compared with the conventional IOL. Conclusion The blue-light filtering IOL improved contrast sensitivity under the condition of glare and low space frequency compared with the conventional IOL. It relieved the post-operative blue opsia symptom,however it did not modify color perception performance.